To Örebro University

Background and Aims: This study aims to compare the incidence of fractures in young T1D individuals vs controls and to explore the association between the frequency of hypoglycemic events and fracture incidence. Previous research has indicated an elevated fracture incidence among individuals with T1D. The predominant hypothesis attributes this increased risk to a higher prevalence of osteoporosis.

Methods: Data on 22,077 (55% males) individuals diagnosed with T1D before the age of 18 years were retrieved from the Swedish National Diabetes Register (NDR) and compared with 110,390 age- and sex-matched controls.

Results: There is a significantly increased risk of fractures in T1D individuals compared to controls (Figure1). This elevated risk isńt seen before T1D diagnosis but is apparent already within the first few years after diagnosis. It is observed in both sexes, with females’ relative risk (RR) 1.4 (95%CI 1.35-1.47) and males’ RR 1.27 (95%CI 1.23-1.30) during the follow up period. In the National Patient Register 0.56 hypoglycemic events/T1D individual with at least one fracture vs 0.3/T1D individual without any fracture were reported. Mean age in the fracture group was 27 years, compared to 22 years in the non-fracture group. A logistic regression model, adjusted for age and duration of T1D, still showed a significantly higher frequency of hypoglycemic events throughout the follow-up period (p < 0.03).

Image (.png) is missing or otherwise invalid.

Conclusions: The increased incidence of fractures in individuals with T1D may, to some extent, be attributed to a higher risk of accidents resulting from hypoglycemic events. Continuous glucose monitoring systems with alarms could be crucial tools to reduce this risk.